Photo by Olga Kononenko on Unsplash

Hospitals are not hotels.

That much should be obvious. They don’t provide personal services tailored to your every whim and fancy. Nor do they provide concierge doctors who will order an MRI for the headache you have as a result of a heavy night down the pub or golf club. They will provide lubrication for instruments that might need insertion to explore your deeper recesses prior to surgery but that is as much luxury as you are going to get. 

In the NHS, the key thing to remember is that it is ‘free at the point of delivery’. Which means you can leave your credit cards and wallet at home and there is no need to negotiate with an insurance company while watching the exsanguination of your visceral organs on the hard shoulder of the M25 after a road traffic ‘event’. 

Mind, there are those who think that is precisely what you should be doing to reduce the cost to the Treasury. The other thing you can do is die early. Take up smoking and stuff highly processed salt and sugary foods at each and every opportunity until your type two diabetes is so bad your foot falls off and your heart explodes in sorrow. That way you can save cash that would otherwise be spent on the extra years over the age of 70 that your miserable bony carcass survives. 

Free at the point of delivery. Fancy that. Of course you have paid already but you have just not paid anywhere near what a simple procedure might set you back if you lived in a third world country, with a piss poor service, like the United States. There, if you so much as pick up the phone to discuss a lump in your trousers, you can kiss your mortgage goodbye. A chap in Chicago had to sell his aircraft carrier to pay for a hernia repair.

Insurance is bloody expensive and they like to exclude as many conditions as possible. If you have had one heart attack in New York the insurance covers the first defibrillator shock, then they charge per shock thereafter at a rate of $1000 a pop. While you crash ashen faced, eyes rolling and involuntarily pissing yourself, each ‘stand back’ you hear is another bill. You might as well just die. Which, happily for them, most poor Americans do. Especially the black ones. Black Lives Matter. Only if they can pay their medical bills. 

This side of the ocean, things are a little different even if there are some who’d like it not to be. Chest pain? Then the very last of your worries is the final bill. And yet, there’s no pleasing some people. 

As waited my turn for the cardiologist and his team to investigate my own pain in an NHS hospital, I had the utter joy to overhear a chap in the next bed down but one. 

“You wouldn’t run a bloody business like this”, harrumphed the git with an over inflated sense of his own importance. A sense that arose, no doubt, as a result of constant ego massaging in childhood as “mummy’s little trooper”. It is a shame the “little trooper” grew up to be a “big twat” whose judgment on health matters is as poor as the pissed up tourist’s order for yet another large Drambuie in a Bangkok brothel staffed entirely by lady boys with unlimited access to oversized butt plugs. The Git sat half slumped on the hospital bed, his face as black as a miner’s arsehole only less picturesque, while his demeanour was nowhere near as sweet. This was due to being told that his cardiac investigative procedure would be later than planned due to some poor sod having the temerity to have an actual heart attack and therefore being in more need of the medical team’s attentions. It is the case that ‘emergencies’ such as one’s life ebbing away with every minute of the ticking clock, take precedent over the ‘urgent’ or the merely ‘planned’ surgical procedures. The NHS is many things, but it takes ‘triage’ quite seriously. 

This means that your ingrowing toenail, chronic dandruff and a perineal wart take second place to actual profuse bleeding from lax orifices. They also take second place to a heart attack that would stop a bull in full charge at the lady bits of cow. Priority is a word Git understands alright, except in his personal world he is his own priority; the sun revolves around him, the universe unfolds at his command, swallows migrate when he allows it. His self centredness probably means he’d give himself his own blowjob if it did not mean he had to make an effort without ‘staff’ to tickle both his ego and scrotum at the same time. 

He probably does run a business, taking sweets from the mouths of cherubim in order to sell them on to diabetics as ‘organic low fat vitamins’. He may organise beggar crippling, to keep the town’s streets free from injured ex servicemen trying to eke out a cold miserable existence living rough, or he may be engaged in selling bottled sunshine to the blind. It has not occurred to him that the NHS is now a collection of independent organisations who are required to contract out services, engaging in competitive tendering, while seeking private providers who have an imperative to generate profits. It used to be a Marxist inspired centrally run Stalinist institution (according to the Daily Mail) providing free at the point of delivery, universal and comprehensive health services. Now it is dealing with increasing demand, rising technological and medical costs and chronic underfunding. Oh, and throw in a pandemic.

Perhaps we should treat cardiac surgery like we treat holidays in the Costa del Sol. Advertise a variety of ‘products’ to suit a range of budgets and tastes, including ‘no frills’ right on up to deluxe premium gold packages.

‘No frills’ means incisions undertaken by a medical student working her fifth 12 hour shift in a row. There would be no analgesia except a pre sucked aspirin, and the procedure would be done in a candle lit shed beside the Starbucks at a roundabout on the A30. The medical student would have only dyspepsia and a deep longing for sleep as accompaniment. The deluxe package includes a personal team headed by an actual cardiologist, access to unlimited chocolate biscuits and a gram of top quality Colombian cocaine in case things get tricky during the procedure.

If I were Health Minister, gits would be filtered out to automatically receive the no frills package while still being charged for Deluxe. 

Some people.

Far away from the villages that nested in the valleys, the Muddlingthrew Hills raised their blue black silhouette against a soon to be rising sun.  The sky was beginning to lighten from the east, provoking a few feathered early risers, keen to get the dawn chorus going, to raise themselves from their nests and find suitable perches to sing and warble. It was going to be a beautiful day. Spring flowers bedecked the country lanes in a profuse display of colour and buds were bursting with joy when touched by the warmth of the  sun. Trees quietly stretched their upper branches towards the heavens and the last of the stars faded into the oncoming light. A pig grunted as it snuffled for roots, a buzzard soared high looking for its breakfast of inattentive small furry creatures, and a village inn’s dog, affectionally known as Trevor, sought out some ‘me time’ behind the brick outhouse in the pub’s yard to carry out some grooming of a personal nature involving his tongue and scrotum. 

If Trevor was not quite so distracted performing his personal grooming, he may have heard the gentle swish swish of a broom and the squeal of a mouse as it bounced off the wall inside the public bar of ‘The Pecker’ as it was affectionally known by the more ribald of Much Sodding’s community. The mouse had shown an uncustomary lack of attention to its peripheral vision as it crossed the floor towards a tempting morsel of beer soaked pork scratching dropped the night before. Eager to gobble it up before the pub cat awoke, he failed to notice the efficiency and effectiveness of the floor cleaning technique being applied just as he darted forward. The next thing that went through his mind was his arse. This was due to rapid deceleration upon being flicked into the air and swept towards the granite lintel over the fire place. His skull stopped suddenly and popped open against the granite a few microseconds before his rear end, but that was enough for the kinetic energy stored therein to fulfil the laws of physics and to ruin the rest of his day. 

The bearer of the broom continued as if nothing had happened sure in the knowledge that ‘Cat’ would soon awake and find an easy breakfast of mouse by the fireplace. 

The broom had plenty of work to do. Last night was a normal night in the pub. The flagstone floor was almost a living history of the goings on. Archaeologists in the future could write whole books about the civilisation they were studying from the collected remains and artefacts found. Except they would not because the broom was adept at sweeping history into the bin. 

A pork scratching would always feature prominently as a core feature of the detritus, along with tobacco ash, coins, a crushed crisp and a condom. A flattened woodlouse, crumbs of soil from the soles of labourer’s boots, cement dust and a lump of hardened snot complete with a nasal hair sticking out of it at a jaunty angle, flicked across the room with about as much attention to where it orbits, as given to the moons of Jupiter. Semi solid sticky stains from liquids various  – both non human and human  – spilled from the tankard through over exuberance while story telling or lack of bladder control, could trap micro dust, finger nails and very small spiders. These poor creatures would come across such dank black edged stains much as we would come across sticky black treacle 2 feet deep. The only difference is that we would avoid stepping in the gooey mess while the poor spider would place each of its eight feet straight in, only to find further progress could not be made. There it would stay, wondering “WTF?” until oblivion was meted out swiftly as a patron of ‘The Pecker’ went for a piss and put it out of its sticky misery under the heel of his boot. 

None of this detail bothered Rosie.

She deftly swept the floor and mopped the stains in preparation for the coming day’s melee at the bar. 

Rosie was described as ‘comely’ by the married men, ‘unavailable’ by the young singletons and ‘cuddly’ by a recent attendee to the village doctor complaining of a bloody nose and a sore scrotum brought on by the swift application of a knee. His mistake was to explore the degree of cuddliness of the object of his (cider sodden) affections by gently squeezing her tits accompanied by the loud vocal encouragement of his cider infused entourage. 

(to be continued)

A crescent shaped slice of orange and the splintered remains of a cocktail umbrella are not a good look stuck to one’s cheek as one stares into the bathroom mirror searching for shred of human dignity. Just as one flushes away last night’s curry round the u bend, it is quickly followed by just that last remnant of dignity and its companion, moral probity. All you have left of a night’s celebratory excess, dancing past midnight, is a buzzsaw headache, what looks like a love bite near your left nipple and the mounting fear of blurred regret bubbling up for something you might have said to your best friend’s mum which involved the letters F, M L and I, but not in that order. As for the lipstick smudged on the base of your penis…?

Such is the joy of being barely into your 20’s when judgment is inverse proportion to the severity of consequence. But it was a New Eve’s party and you only die once. If one could go back and have a little chat with one’s former self, what advice or resolutions would be put in place? How would life have been improved ‘if only’?

This being the 1st of January, it is customary to reflect upon the errors of one’s ways and resolve to live a more productive, healthy and wealthier life. It is also customary for some celebrity A list twat to try and sell you happiness and wellbeing in the form of creams made from the secretions of the sexual glands of a soon to be extinct small mammal in Sri Lanka, an array of superfoods with exotic names which in the local language translates as ‘berry‘ ‘nut‘ and ‘don’t eat that, it is fucking dangerous‘, and the latest iteration of an eastern religious mythology involving energy forms and bat licking while you twist your legs and arms into positions only porn stars are comfortable with.

Resolutions usually fall into the various categories of a) weight loss b) finances c) fitness or d) self improvement through the acquisition of a new skill such as learning Hebrew (Old Testament version – the one without Jesus in it). However, the flaw in most people’s attempts at putting these resolutions into practice is that they are hard work and we are just not built for that. If you believe the bullshit in every Sunday supplement for the next week on how to better yourself, in just a few weeks with a bit of free will you too can be Joe Wicks who cooks like Nigella while writing a play in Latin while paying off your overdraft and saving enough for a piede-à-terre in Tuscany. Instead, by March, you’ll be slumped in front of old reruns of Downton Abbey, a slice of Victoria sponge smearing strawberry jam across one cheek having put on half a stone while reaching for a tissue to wipe your snotty nose as you weep into a small tumbler of gin.

Let’s face it, you will be in no position of moral authority to tell your twenty year old self to go easy on the rum daiquiris at your mate’s New Years eve party. Your present self is about as qualified to coach your past self into the path of righteousness as a Ghislaine Maxwell is qualified to offer advice to schoolgirls about going to parties attended by forgetful celebs who have no need of a bit of roll on anti-perspirant.

A short while ago a Canadian clinical psychologist decided that the world needed a bit of a slap and a wake up call. His name is Jordan Peterson and he has gone on to make a good deal of money putting liberals and feminists ‘in their place’ for daring to transgress the laws of God. He agues that women and nature are both chaotic. They are actually ‘Chaos’. Women are so because they are closer to nature than men because of their baby producing capability. This idea has a long history, especially among the three abrahamic faiths that fear female sexuality and women’s ability to tell men to fuck off at will. As most men are focused on impregnating anything that looks and feels soft, and of course human  like in form especially with tits, access to the channels of fecundity is a) the only thing they think about and b) are terrified they are not up to it and c) will die lonely and old, wanking themselves into oblivion while more handsome men are allowed into the female fold. To avoid the tsunami of involuntary celibacy, and to ensure that any money they spend bringing up a child is spent on bringing up the right child – i.e. his own seed – they needed to control women’s legs. Specifically who they spread them for. So men came up with the idea that just as the nature (wind, rain, crops and volcanoes) is often beyond our control, so could women because they are nature. Therefore they need to be controlled.

So you need rules. You need to exert control and order though rules. To prevent modern post industrial technologically advanced societies going the way of Rome, there has to be Order. So Peterson came up with ’12 rules’, which is a load of old bollocks about petting cats, letting kids skateboard and not telling fibs. Who knew? 

Anyway. 

If Peterson can do it, so can I. Here are my 12 Rules for Life.

1. If you enjoy a few pints of Guinness and a curry, never trust the first fart of the morning.  Never trust a fart in front of your new mother in law. Never trust a fart on a bike. Never trust a fart in India. You’d be best trusting a fart like you’d trust a Nigerian Prince with an investment who needs your bank details. 
2. If you come across a cat in the streets, don’t go near the fucking thing. It might have airborne tranmissable syphilis and a penchant for ripping its claws into the faces of unwary human beings. Cats are dangerous and only tolerate humanity for what they can get out of us. A stranger on the street is to them an unreliable source of food and smell strange. When did you last have a tasty titbit to offer a feral ginger while out and about doing your shopping? Thought not. 
3. Treat yourself like you deserve everything there is on offer. Don’t listen to those who call you a vacuous wastrel, a useless freeloading bastard and a complete waste of skin. You are beautiful (probably on the inside at least) and the opinions of others are not to be trusted even if you do call them ‘mother’.
4. When going for a ‘back, sack and crack’, ensure you have a) a sack and b) a bag of  amusing anecdotes to keep the beauty technician in a good mood while they administer hot wax and bonhomie. If you don’t have a ‘sack’, ask for an anal bleach instead. Any self respecting beauty salon should be willing to dive in between your cheeks with gusto and whiten the starfish before you can say ‘porn star’.
5. Choose your friends wisely. Ideally they should be loaded, free with their generosity and easy to get pissed. Look for the gullible, the naïve and the weak. Their moral sensibilities should be non existent and their suggestability should be off the scale. Getting naked in public should be a given. 
6. Wear sun screen, nipple wax and thong cream. 
7. Don’t go anywhere near children. Especially your own. Other people’s will at least fuck off at tea time. Never drop your guard and let your friends who have kids feel even the tiniest bit welcome when they visit. If you do, you’ll be hoovering up biscuit crumbs from behind the sofa for the next fortnight, putting in an insurance claim and discovering they have pissed everywhere except the toilet bowl. If they want a poo in your new bathroom, don’t let them. You will find smear stains in places you’d never think could stain. 
8. Criticise everything and everybody. You will feel a warm glow of superiority and your friends and work colleagues will thank you for pointing out their errors and misjudgments. People say they don’t like being criticised but they do. Most people are stupid useless wankers who have an endless capacity for ignorance, mistakes and self delusion. If you are new to the game, start by criticising a junior colleague’s hairdo by making reference to old standards such as ‘birds nest’, ‘hedge backwards’ or the more modern reference to ‘poor genes’ and ‘the eugenicists have a point’. Work your way up to peers before trying it out on the Head of Department by calling them a ‘useless c*nt. who only got the job by shoving their nose between the CEOs buttocks’. However, avoid doing this to the tattooed scaffolder in the pub. 
9. That reminds me: “Try not to be a c*nt’, then ’Don’t be a c*nt’. If it is too late, then ‘Stop being a c*nt’. Remember the acronyms: TNTBAC, DBAC and SBAC. 
10. Swear. It is good for the soul and makes you feel really nice. Don’t listen to the prissy naysayers who bang on about it being a christening/wedding/funeral. Liven up your best man’s speech or your eulogy. Sprinkle the well worn cliches with the odd bastard, fuck and twatface. These words bring fresh life to a cliche like a defibrillator does to the comatose. Learn to leave the C bomb until its really ripe for doing so. Your maiden aunt and the vicar will love you for it. 
11. Don’t go near any religion. That’s the road to hell, to pinch a phrase. You are at heart a boozing, swearing philanderer who likes nothing more than than a piss up and porn. You love a Guinness, a curry and farting as you give the best man’s speech. This is true even if you are a woman. Religion will strip you of your sense of humour, your intelligence and the utter joy of an uncomplicated and guilt free wank. Especially avoid austere Protestantism and the more literal forms of faith. They tend to frown upon your favourite weekend pursuits and will separate you from foreskins and labia with a rusty knife and a prayer given half a chance. 
12. Don’t listen to anybody who tells you there are ’12 Rules for Life’. There aren’t. There is only 1: Live it. You are born an innocent, as pure as an uncut kilo of cocaine. You are not a bad person, just a curious one. And if you do bad things, try to learn from it. The second Rule for Life is simply go out there and exercise love for others and the world. 

That’s it. You can fuck off now.

Its not funny being old.

And as that is a state most of us in the rich developed world will experience,  we’d better get a grip of life’s challenges and opportunities while we have the capabilities to do so.

One challenge is not to make comedy out of simply being old itself; to treat it as one homogenous experience in which we all descend into a wrinkly, toothless, incontinent, mindless state, tinged with petty racism and dominoes. I think I might have just failed that test, probably because I’ve just pissed myself on the train because I’ve forgotten how to use a toilet. I blame this on immigration. 

1 in 20 over the age of 60, 1 in 3 over the age of 80. If that is the answer, what is the question? Is it: how many people in the UK were born in the UK? How many people know that most statistics are randomly selected to suit an argument? How many people know that ‘muffin the mule’ is not a euphemism? The real answer is: how many people will have dementia in the UK? This is not funny. Not even remotely funny and made worse by our collective, and probably wilful, neglect of the cost to individuals and families and our seeming unwillingness to address this as a society. 

GPs have stated that many of them lack the training required to adequately address dementia. There is not a nationally implemented evidence based care pathway accessible to all. Services are disjointed and sometimes hardly in existence while social care is means tested and complex. The result is that carers face an enormous burden every single day. Dementia hits at least two people, the person diagnosed, and their carer. The social, economic and mental health cost is taken up by individuals and their families. 

We seemingly have lost the will to respond collectively to this health and well being issue. Or should that be the Ruling Party, who represent wealth, never did have the will to address this because they have nanny and a nice littler earner in the British Virgin Isles looking after their constituents in raid sodden Redditch.

Thatcher after all said there is no such thing as society, only individuals and families. So, now we’d rather let individuals and families carry the major burden for dementia care because thats the ‘right thing to do’. After all, it is the families’ responsibility to care and to love. ‘We’ justify this position by arguing that it is the individual and the family who are best placed to make decisions about health and social care and can therefore make better choices than a stalinist NHS. If you get old, that is your choice and you should make provision for it. Why should ‘hard working families’ pay taxes to look after your rag tag bag of wrinkly skin and bones? Wipe your own arse before asking nanny to do it. You can of course choose to spend your money on a cruise or care. Your choice. 

So in this spirit, I offer you the following to help you make better choices. 

If you want care when you can’t remember your name, then make provision for it now:

1. Have children. Do not do what the feckless, limp wristed ‘gays’ do. Who else is going to look after you if you swan about worrying about interior design? Gays could put the money they save on bringing up children into investments for social care instead of cruising and singing old Dorothy Day hits of the fifties. 
2. Have daughters. Sons are useless. Sons work, and end up getting drunk and shagging. They also move about the country a bit. Daughters however can be socialized into nurturance and a self loathing which can only be assuaged by helping others, often without pay! Thats why they go into nursing. because they like to ‘make a difference’ and to provide ‘compassionate care’. Care work is ‘character based moral labour’ and thus enables the basic caring intuitions of daughters to be exploited, er, ’empowered’. Two daughters are ideal because they can guilt trip each other about not caring for poor old mum or dad, thus ensuring at least one will be there for you. Repeat, don’t bother too much about sons, unless he gets a decent job to pay for all your incontinence equipment. Sons can’t be guilt tripped as easily as daughters. Especially when the football is on. 
3. Be nice to your daughters. But you don’t have to overdo it because of point two. 
4. Be at least middle class (by that I mean proper middle class). Earn enough to send your kids to private school/Oxbridge/jobs in the City, marketing or law. Middle class means knowing what polenta is, that a Margaux is a red (wine) and living in Surrey. Its not picking your nose in public, showing your tits at a party or Redruth. Its having a gap year not a gap in your education. Earn enough for a cleaner and for a nice middle class carer on her gap year “doing this to give something back”. 
5. Get a decent tax accountant well versed in schemes to hide your wealth from the skivers. Ensure they are well up on inheritance issues.
6. Earn enough to need a tax accountant to address inheritance issues. 
7. Marry a rich person. Proper rich. The sort that can afford the staff in their holiday home in Bermuda.
8. Vote conservative so that the feckless poor don’t bleed you dry.
9. Avoid the NHS like the plague ridden pox house it is. Employ a concierge doctor and have consultants in your social circle. Ensure you have private health insurance, better still own a private health clinic. Choose your nurses personally, you know the type. Comely wenches are ok but better still get cheap ones from foreign places. 
10. Never be seen to eat in Nando’s. Shop at Lidl, better still get your staff to shop there and put the savings in you personal pension fund. 
11. Make friends with the wife of an Eton Educated Prime Minister.
12. Don’t lend money to your friends, enemies or Greece. 
13. Choose your family, make sure they are not poor.
14. Blame it all on immigration, the weather and the 1960’s.
15. Don’t use public transport in case you pick up a nasty infection, or see a poor person with their  funny ideas about ‘social solidarity’. 
16. Avoid the the pinko soft liberal BBC with its bias towards the NHS, unless its ‘Gardner’s Question Time’. Support Murdoch and his chums in their quest to kill the BBC off, that way you won’t have to listen to that dreadful leftie Huw ‘Look at me I’m Welsh’ Edwards telling you how the NHS needs more money (your money). We all know how the Welsh are to the left of Lenin, its all those valleys, phlegm and close harmony singing that does it. Makes the brain damp with all that rain. 
17. Never refer to facts, academic research or social science in case the facts get in the way of your arguments about privatizing health and education. General taxation for both may cost you money which will not be available to you to pay for care. In any case, facts only make life uncomfortable and can, if exposed to them for long enough, begin to change your mind about the undeserving underclass.
18. Go to to Eton for your schooling. If thats not possible make lots of friends who did. 
19. Consider moving to London; not Southwark or anywhere else south of the river of course. 
20. Don’t mix with the ‘little people’; you know, the ones who actually pay tax. I refer you to point 15. They might pester you with ridiculous ideas about collective action or how the NHS is worth saving.
21. You could of course just die early.
22. Switzerland. Now, I’ve heard its a lovely country.

Thats my recipe for beating dementia. I forgot the other two. 

You may wish to refer to this list as “Tory Health Policy”, or ‘F*ck you jack, I’m all right’.